Healthcare Provider Details

I. General information

NPI: 1679346282
Provider Name (Legal Business Name): KATIE ONG, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2023
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 E MAPLE RD STE 207
BIRMINGHAM MI
48009-6411
US

IV. Provider business mailing address

4302 SHERIDAN DR
ROYAL OAK MI
48073-6232
US

V. Phone/Fax

Practice location:
  • Phone: 248-225-7269
  • Fax:
Mailing address:
  • Phone: 248-225-7269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KATHRYN JANE ONG
Title or Position: MASTER'S LEVEL PSYCHOLOGIST
Credential: MA, LLP
Phone: 248-225-7269